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Postprocessing of MRIs Using FreeSurfer in Epilepsy Surgery Patients Provides an Excellent Imaging Marker of Hippocampal Sclerosis but Fails to Separate Subtypes.

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Title: Postprocessing of MRIs Using FreeSurfer in Epilepsy Surgery Patients Provides an Excellent Imaging Marker of Hippocampal Sclerosis but Fails to Separate Subtypes.
Authors: Kloster, Ane G. (AUTHOR), Opheim, Giske (AUTHOR), Alfstad, Kristin Å. (AUTHOR), Larsen, Karen B. (AUTHOR), Niehusmann, Pitt (AUTHOR), Holm, Emil (AUTHOR), Fink-Jensen, Philip (AUTHOR), Lund, Eva Løbner (AUTHOR), Jespersen, Bo (AUTHOR), Ivanovic, Jugoslav (AUTHOR), Rubboli, Guido (AUTHOR), Madsen, Camilla G. (AUTHOR), Marthinsen, Pål B. (AUTHOR), Ganz, Melanie (AUTHOR), Lossius, Morten (AUTHOR), Pinborg, Lars H. (AUTHOR)
Source: Acta Neurologica Scandinavica. 5/24/2023, p1-10. 10p.
Subjects: Hippocampal sclerosis, Temporal lobectomy, Epilepsy surgery, People with epilepsy, Minimally invasive procedures, Image processing
Abstract: Objective. Histopathological examinations will diminish as minimally invasive epilepsy surgery increasingly replaces open surgery. The objective of this study was to test if visual and computer-aided quantitative analyses of presurgical high-quality 3 Tesla MRIs complying with the International League Against Epilepsy (ILAE) Neuroimaging Task Force recommendations can inform on histopathological diagnosis. Methods. Ninety-two patients from Copenhagen and Oslo University Hospitals fulfilled patient-, imaging-, and histopathological inclusion criteria: 69 patients were diagnosed with hippocampal sclerosis (HS) ILAE type 1 or 2, and 23 patients had normal appearing hippocampi or other histopathology than HS (no-HS). MRIs from 52 healthy controls (HC) were included. Image processing was performed in FreeSurfer v.6.0 with the built-in cross-sectional hippocampal subfield segmentation tool and multimodal MRI input. Volume outputs were used to calculate volume asymmetry ratios (VARs) for whole hippocampus (WH) and subfields. Results. HS patients had significantly larger WH VARs compared to no-HS patients and HC, with a sensitivity = 0.93 and specificity = 1.0 for histopathological HS diagnosis. Visual MRI assessment yielded a sensitivity = 0.90 and specificity = 0.96 for histopathological HS diagnosis. CA1 and CA4 VARs and the number of seizure-free patients were not significantly different in HS ILAE type 1 compared to type 2 patients. Significance. FreeSurfer analyses of presurgical MRIs are excellent at separating patients histopathologically diagnosed with HS from patients with other pathology or normal appearing hippocampi. Using the FreeSurfer hippocampal subfield segmentation tool did not allow for separating HS ILAE subtypes. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
  Group: Ti
  Data: Postprocessing of MRIs Using FreeSurfer in Epilepsy Surgery Patients Provides an Excellent Imaging Marker of Hippocampal Sclerosis but Fails to Separate Subtypes.
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  Data: <searchLink fieldCode="AR" term="%22Kloster%2C+Ane+G%2E%22">Kloster, Ane G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Opheim%2C+Giske%22">Opheim, Giske</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Alfstad%2C+Kristin+Å%2E%22">Alfstad, Kristin Å.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Larsen%2C+Karen+B%2E%22">Larsen, Karen B.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Niehusmann%2C+Pitt%22">Niehusmann, Pitt</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Holm%2C+Emil%22">Holm, Emil</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fink-Jensen%2C+Philip%22">Fink-Jensen, Philip</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lund%2C+Eva+Løbner%22">Lund, Eva Løbner</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jespersen%2C+Bo%22">Jespersen, Bo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ivanovic%2C+Jugoslav%22">Ivanovic, Jugoslav</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rubboli%2C+Guido%22">Rubboli, Guido</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Madsen%2C+Camilla+G%2E%22">Madsen, Camilla G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Marthinsen%2C+Pål+B%2E%22">Marthinsen, Pål B.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ganz%2C+Melanie%22">Ganz, Melanie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lossius%2C+Morten%22">Lossius, Morten</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pinborg%2C+Lars+H%2E%22">Pinborg, Lars H.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. 5/24/2023, p1-10. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Hippocampal+sclerosis%22">Hippocampal sclerosis</searchLink><br /><searchLink fieldCode="DE" term="%22Temporal+lobectomy%22">Temporal lobectomy</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy+surgery%22">Epilepsy surgery</searchLink><br /><searchLink fieldCode="DE" term="%22People+with+epilepsy%22">People with epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Minimally+invasive+procedures%22">Minimally invasive procedures</searchLink><br /><searchLink fieldCode="DE" term="%22Image+processing%22">Image processing</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective. Histopathological examinations will diminish as minimally invasive epilepsy surgery increasingly replaces open surgery. The objective of this study was to test if visual and computer-aided quantitative analyses of presurgical high-quality 3 Tesla MRIs complying with the International League Against Epilepsy (ILAE) Neuroimaging Task Force recommendations can inform on histopathological diagnosis. Methods. Ninety-two patients from Copenhagen and Oslo University Hospitals fulfilled patient-, imaging-, and histopathological inclusion criteria: 69 patients were diagnosed with hippocampal sclerosis (HS) ILAE type 1 or 2, and 23 patients had normal appearing hippocampi or other histopathology than HS (no-HS). MRIs from 52 healthy controls (HC) were included. Image processing was performed in FreeSurfer v.6.0 with the built-in cross-sectional hippocampal subfield segmentation tool and multimodal MRI input. Volume outputs were used to calculate volume asymmetry ratios (VARs) for whole hippocampus (WH) and subfields. Results. HS patients had significantly larger WH VARs compared to no-HS patients and HC, with a sensitivity = 0.93 and specificity = 1.0 for histopathological HS diagnosis. Visual MRI assessment yielded a sensitivity = 0.90 and specificity = 0.96 for histopathological HS diagnosis. CA1 and CA4 VARs and the number of seizure-free patients were not significantly different in HS ILAE type 1 compared to type 2 patients. Significance. FreeSurfer analyses of presurgical MRIs are excellent at separating patients histopathologically diagnosed with HS from patients with other pathology or normal appearing hippocampi. Using the FreeSurfer hippocampal subfield segmentation tool did not allow for separating HS ILAE subtypes. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1155/2023/2366355
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      – Code: eng
        Text: English
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        PageCount: 10
        StartPage: 1
    Subjects:
      – SubjectFull: Hippocampal sclerosis
        Type: general
      – SubjectFull: Temporal lobectomy
        Type: general
      – SubjectFull: Epilepsy surgery
        Type: general
      – SubjectFull: People with epilepsy
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      – SubjectFull: Minimally invasive procedures
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      – SubjectFull: Image processing
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      – TitleFull: Postprocessing of MRIs Using FreeSurfer in Epilepsy Surgery Patients Provides an Excellent Imaging Marker of Hippocampal Sclerosis but Fails to Separate Subtypes.
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              Text: 5/24/2023
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